TY - JOUR. T1 - Endarterectomy for asymptomatic high-grade internal carotid artery stenosis-Does age alone really matter?. AU - Assadian, Afshin. AU - Taher, Fadi. AU - Assadian, Ojan. PY - 2016/9/20. Y1 - 2016/9/20. N2 - Background The aim of this retrospective observational study was to assess whether patients ≥ 75 years of age had a significantly inferior 5-year stroke free survival rate compared to patients ,75 years of age after carotid endarterectomy under regional anesthesia. Methods All consecutive patients with asymptomatic high-grade internal carotid artery (ICA) stenosis operated on from January 1997 to December 1999. Of 273 consecutive patients with asymptomatic carotid artery stenosis, follow up was complete for 253 patients. Results Of 253 patients, 152 were younger and 102 older than 75 years at surgery (65 ± 8 years (range 43-74) and 79 ± 4 years (range 75-90); P , 0.001), respectively. Perioperatively, 4 patient developed stoke (1.6%), 2 in each group (1.3% and 1.6%, ...
TY - JOUR. T1 - The use of covered stents for the endovascular treatment of extracranial internal carotid artery stenosis. T2 - A prospective study with a 5-year follow-up. AU - Szólics, Alex. AU - Sztriha, László K.. AU - Szikra, Péter. AU - Sźlics, Mikĺs. AU - Palḱ, András. AU - Vörös, Erika. PY - 2010/7/1. Y1 - 2010/7/1. N2 - Objectives: To evaluate the safety and feasibility of the use of covered stents for the treatment of extracranial carotid artery stenosis caused by highly embologenic plaques, and to study the long-term outcome of patients receiving such covered stents. Methods: Between 2002 and 2007, 46 patients (63% symptomatic, 78.3% male, 67± 8.6 years old) with internal carotid artery stenosis caused by embologenic plaques or restenosis were treated with self-expanding covered stents (Symbiot, Boston Scientific). Pre-dilatation or protecting devices were not used. Post-dilatation was applied in every patient. Each patient was followed long-term. The outcome measures were ...
The internal carotid artery is a major paired artery, one on each side of the head and neck, in human anatomy. They arise from the common carotid arteries where these bifurcate into the internal and external carotid arteries at cervical vertebral level 3 or 4; the internal carotid artery supplies the brain, while the external carotid nourishes other portions of the head, such as face, scalp, skull, and meninges. Terminologia Anatomica in 1998 subdivided the artery into four parts: "cervical", "petrous", "cavernous", and "cerebral". However, in clinical settings, the classification system of the internal carotid artery usually follows the 1996 recommendations by Bouthillier, describing seven anatomical segments of the internal carotid artery, each with a corresponding alphanumeric identifier-C1 cervical, C2 petrous, C3 lacerum, C4 cavernous, C5 clinoid, C6 ophthalmic, and C7 communicating. The Bouthillier nomenclature remains in widespread use by neurosurgeons, neuroradiologists and neurologists. ...
[Endarterectomy for cervical internal carotid artery stenosis accompanied with severe aortic valve stenosis--case report].: A 75-year-old man, who had undergone
In this report, a case of anomalous internal carotid artery looping into the orbital apex is presented. The patient was a 41-year-old man with sudden onset headache, suggestive of aneurysmal subarachnoid hemorrhage (SAH). Imaging with CT demonstrated a perimesencephalic distribution of blood. Cerebral angiography confirmed non-aneurysmal, perimesencephalic SAH, but incidentally noted an anomalous left internal carotid artery with a course into the orbital cone. This is the only known example of this anatomic variation. Potential embryological explanations are discussed. ...
The internal carotid plexus (internal carotid plexus) is situated on the lateral side of the internal carotid artery, and in the plexus there occasionally exists a small gangliform swelling, the carotid ganglion, on the under surface of the artery.. Postganglionic sympathetic fibres ascend from the superior cervical ganglion, along the walls of the internal carotid artery, to enter the internal carotid plexus. These fibres then distribute to deep structures, which include the Superior Tarsal Muscle and pupillary dilator muscles.[1] Some of the fibres from the internal carotid plexus converge to form the deep petrosal nerve.[2]. The internal carotid plexus communicates with the trigeminal ganglion, the abducent nerve, and the pterygopalatine ganglion (also named sphenopalatine); it distributes filaments to the wall of the internal carotid artery, and also communicates with the tympanic branch of the glossopharyngeal nerve.. ...
|b||i|Background:|/i||/b| To investigate the correlation between tortuosity of extracranial internal carotid artery (EICA) and intraprocedural complications in patients undergo
Details of the image Right middle cerebral artery territory infarct from right internal carotid artery dissection Modality: CT (non-contrast)
This lateral view from an internal carotid artery angiogram demonstrates the origin of the ascending pharyngeal artery from the cervical internal carotid artery, which is an unusual but normal variant of angiographic anatomy. Normally, the ascending pharyngeal artery arising from the proximal external carotid artery. - Stock Image C007/5818
Clinical record. A 33-year-old man presented to an emergency department with acute dysphasia and a dense right hemiparesis. His National Institute Health Stroke Scale score was 12, indicating a moderate severity stroke (score range 0-42, with increasing values indicating increasing severity). His computed tomography (CT) brain scan was normal. A CT angiogram showed a filling defect in the left intracranial internal carotid artery. Intravenous thrombolysis was commenced 2.5 hours after stroke onset and completed during urgent transit to our hospital for endovascular thrombectomy. Combined stent retrieval and suction thrombectomy of the left internal carotid occlusion restored flow 4.5 hours after stroke onset. A small dissection in the left intracranial internal carotid artery was the source of the thrombotic occlusion (Figure). A magnetic resonance imaging scan of the brain showed small scattered infarctions in the left middle cerebral arterial territory.. The patient was later found to have a ...
TY - JOUR. T1 - Advantages of Staged Angioplasty in a Patient with Internal Carotid Artery Pseudo-Occlusion Besides Prevention of Cerebral Hyperperfusion Syndrome. AU - Takahashi, Satoshi. AU - Akiyama, Takenori. AU - Nakahara, Jin. AU - Yoshizaki, Takahito. AU - Suzuki, Norihiro. AU - Yoshida, Kazunari. PY - 2018/1/1. Y1 - 2018/1/1. N2 - Background Staged angioplasty for carotid artery stenosis has been reported to be effective in preventing postoperative cerebral hyperperfusion syndrome (CHS) in patients with severe carotid stenosis; thus, it is also recommended for patients with internal carotid artery (ICA) pseudo-occlusion, the treatment strategy for which is controversial. Case Description This study reports the case of an Asian man in his 50s who had motor aphasia and right-side weakness caused by pseudo-occlusion of the left ICA. After medical treatment, he underwent a staged angioplasty. After the first stage of percutaneous transluminal angioplasty, anterograde blood flow to the left ...
Using positron emission tomography in nine patients with minor strokes, unilateral internal carotid artery occlusion, and good collateral circulation through the anterior portion of the circle of Willis, we analyzed regional cerebral blood flow, cerebral metabolic rate of oxygen, oxygen extraction fraction, and cerebral blood volume. These studies allowed quantification of the regional hemodynamic status, especially in relation to watershed areas. Compared with eight normal controls, the patients had significantly (p less than 0.01) decreased regional cerebral blood flow in the middle cerebral artery territory and the surrounding watershed areas of the occluded hemisphere. The oxygen extraction fraction rose with the distance from the anterior portion of the circle of Willis, attaining the highest value in the superior parietal and posterior temporo-occipital watershed area. A concomitant decrease in the cerebral blood flow/cerebral blood volume ratio suggested reduction in the mean blood flow ...
The experiment was carried out on 100 symptomatic patients with internal carotid artery stenosis that underwent carotid endarterectomy. Every patient had the wall of the carotid artery resected during organ harvesting surgery in order to evaluate some cytokines (TGF-β, VEGF, FGF, TNF-α) and to perform the immunohistochemistry (IHC). An immunoreactive score (IRS) was calculated based on the staining intensity and the number of cells stained. Over a 3-year period, 7 patients died, and 2 patients were lost to follow-up. The study group consisted of 91 patients. The control group comprised 20 young organ donors with confirmed death brain, who had their normal carotid artery sampled. In all healthy donors (control group) with normal carotid arteries the three cytokines (TGF-β, VEGF, TNF-α) were not discovered. The presence of FGF was confirmed in 25% of healthy donors, probably due to an intima fibroblasts activity, responsible for the synthesis of elastin and collagen to the extracellular matrix (ECM).
Forty consecutive patients undergoing thromboendarterectomy for total internal carotid artery occlusion were studied in an attempt to determine a) whether careful case selection could be expected to reduce future postoperative mortality and morbidity, b) whether the achieved patency rate justified early operation and c) whether patients in whom patency was restored and maintained had a better long-term prognosis. The results show that a group of patients can be selected that will have low postoperative mortality and morbidity. The success rate for restoration of blood flow is high, particularly if the operation is performed soon after occlusion. The long-term prognosis in patients in whom patency of the internal carotid artery is restored and maintained appears to be better than in those with persistent occlusion of the carotid artery. ...
Figure 2 Step-by-Step Carotid Artery Stenting. (A) Bilateral visualization using a diagnostic catheter in the right internal carotid artery. During proximal protection with flow blockage (Medtronic Invatec MoMa, Roncadelle, Italy), a standard 0.014-inch coronary wire was inserted in the dissection and could not be advanced further (arrow). A hydrophilic polymeric 0.014-inch wire (Fielder FC, Asahi-Intecc, Aichi, Japan) (arrowhead) over a coronary microcatheter (Finecross, Terumo, Tokyo, Japan) (black arrow) managed to re-enter the true lumen distally (B, C). (D) Wire progression was controlled by performing contralateral injections. Once the wire reached the midcerebral artery (E), the microcatheter was advanced (F), and the position was checked again with gentle injection of contrast medium (G). (H) The hydrophilic wire was exchanged for a standard one with a trapping balloon inside the MoMa catheter. After predilations with 3.5-mm balloons, 2 open-cell stents (Precise 7-40 mm, Cordis, Fremont, ...
A complete occlusion of the internal carotid artery (ICA) is an important cause of cerebrovascular disease. A never-symptomatic ICA occlusion has a relatively benign course, whereas symptomatic occlusion increases future risk of strokes. Ultrasonography, magnetic resonance imaging and contrast angiography are useful diagnostic tests, and functional imaging of the brain (eg, with positron emission tomography) helps to understand haemodynamic factors involved in the pathophysiology of brain ischaemia. Recently, there has been a resurgence of interest in the role of extracranial-intracranial bypass surgery for the treatment of completely occluded ICA. With advances in the measurement of cerebral haemodynamics, it may be possible to identify high-risk patients who could benefit from the bypass surgery ...
TY - JOUR. T1 - Branches of the petrous and cavernous segments of the internal carotid artery. AU - Tubbs, R. Shane. AU - Hansasuta, Ake. AU - Loukas, Marios. AU - Louis, Robert G.. AU - Mohajel Shoja, Mohammadali. AU - Salter, E. George. AU - Oakes, W. Jerry. PY - 2007/9/13. Y1 - 2007/9/13. N2 - Microsurgical approaches to the skull base require a thorough knowledge of the microvasculature of this region. Interestingly, most standard texts of anatomy do not mention the branches of the internal carotid artery as it travels through the temporal bone and cavernous sinus. Although small and with often conflicting descriptions, these arterial branches may be of significance when contributing to the vascular supply of such pathological entities as meningiomas and vascular malformations. Furthermore, multiple anastomoses exist between these branches and branches of the external carotid artery, thus providing a potentially important collateral circulation between these two systems and thus retrograde ...
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The duplex scan is the main tool used to diagnose carotid artery stenosis, and there is agreement that it might be the single preoperative diagnostic test. All limitations of carotid duplex scanning should be taken into consideration during qualification to surgical or endovascular treatment. Awareness of these limitations is especially important when neurological symptoms are typical and duplex examination is negative. The authors describe the pitfalls of the duplex scan examination in a symptomatic patient with bilateral severe distal internal carotid artery stenosis ...
We present a case of supraclinoid internal carotid artery dissection. Eleven months prior, the patient developed isolated periorbital pain and was diagnosed with giant-cell arteritis with iritis. The patient experienced recurrent spells concerning for transient ischaemic attacks and was transferred to our institution for endovascular intervention after head CT revealed an embolic infarct with a dense middle cerebral artery sign. Digital subtraction angiography was negative for occlusion, instead demonstrating luminal stenosis and poststenotic dilatation. He subsequently experienced acute neurological decline secondary to massive subarachnoid haemorrhage. Non-invasive vascular imaging revealed an intimal flap and a pseudoaneurysm at the site of luminal stenosis, confirming our suspicion for intracranial carotid artery dissection. Given the moribund clinical state, the family opted to withdraw care, and he quickly expired. ...
TY - JOUR. T1 - Correlation of continuous-wave Doppler spectral flow analysis with gross pathology in carotid stenosis. AU - Call, G. K.. AU - Abbott, W. M.. AU - Macdonald, N. R.. AU - Megerman, J.. AU - Davis, K. R.. AU - Heros, Roberto. AU - Kistler, J. P.. PY - 1988/1/1. Y1 - 1988/1/1. N2 - Preoperative continuous-wave Doppler spectral analysis was used to generate two parameters, peak frequency in the internal carotid artery (f(max)) and the ratio of peak frequencies in the internal and common carotid arteries (carotid index). These were compared with direct measurement of residual lumen diameter in pathologic specimens obtained from carotid endarterectomy in 37 patients. Doppler shift frequency parameters were well correlated with residual lumen diameter when the latter was at least 1 mm. Residual lumens of ≤2 mm were found to have an f(max) of ,7.5 kHz and a carotid index of ,3.8. If f(max) was ,14 kHz or the carotid index was ,7, the residual lumen diameter was nearly always ≤1 mm. ...
Sickle cell disease (SCD) increases the risk for stroke by 200 to 400 times; 5-8% of patients with SCD develop symptomatic cerebrovascular disease. Sickled cells adhere to vessel walls leading to intimal and medial damage and subsequent stenosis and occlusion. Sickle cell vasculopathy (SCV) affects small and large vessels but the distal internal carotid artery and the proximal middle cerebral arteries are the most commonly involved.. Transcranial Doppler is useful as a screening tool to predict SCV. Time averaged mean velocities ,170 cm/sec may indicate hemodynamically significant stenosis and require MR angiography for anatomic confirmation. Exchange transfusion may reverse the perfusion disturbance diagnosed by Doppler and MR angiography.. Moya moya is a description of progressive stenosis of the supraclinoid internal carotid artery with enlargement of the perforating arteries and development of collateral vessels at the circle of Willis giving rise to a "puff of smoke" appearance. Moya moya ...
Journal of Ophthalmology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the anatomy, physiology and diseases of the eye. Submissions should focus on focusing on new diagnostic and surgical techniques, instrument and therapy updates, as well as clinical trials and research findings.
The prevalence of internal carotid artery (ICA) morphological variations (MV), their characteristics, and their possible association with carotid stenosis, vascular risk factors, and previous transient ischemic attack or ischemic stroke was investigated in a consecutive series of patients.Within a seven-month period, 1217 patients (557 men and 660 women; mean age [ SD] 62.718.1 years) consecutively referred to the Laboratory of Neurosonology, University of LAquila, Italy, underwent a neck vessel examination using a high-resolution B-mode ultrasound device with a 7.5 MHz linear phased array probe.ICA MV were present in 319 (26.2%) patients; they were unilateral in 201 patients (63.0%) and bilateral in 118 patients (37.0%). Patients with ICA MV were older than those without ICA MV (66.319.9 years versus 61.418.0 years, P,0.0001) and were mostly women (62.4%, P=0.0008). Tortuosity was present in 195 (44.6%) arteries, kinking in 236 arteries (54.0%) and coiling in six arteries (1.4%). Carotid ...
The internal carotid artery enters the skull and supplies the anterior part of the brain (via cerebral branches), the eye and its appendages, and sends branches to the forehead and nose. It has many curvatures in different parts of its path. When it passes through the carotid canal and the side of the body of the sphenoid bone, it has...
Antithrombotic treatment of ischemic stroke among patients with occlusion or severe stenosis of the internal carotid artery: A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST).
Useful mnemonics to remember the branches of the internal carotid artery is: A VIPS COMMA calming voices make intra-operative surgery pleasurable and almost memorable Mnemonics A VIPS COMMA A: anterior choroidal artery (C7) V: Vidian arte...
A, Measurement of internal carotid artery (ICA) calcification by semiquantitative methods. A region of interest is drawn around the calcified artery in a wide w
This is an article about the segments, branches and clinical aspects of the internal carotid arteries. Learn all about these important blood vessels here!
KAZEM FATHIE, M.D., F.A.C.S., F.I.C.S., Ph.D. THE patient whose case I shall describe had a large aneurysmal tumor of the internal carotid artery. It had
This 48 year old woman presented to the department of vascular surgery due to recurrent pain in both legs. She suffers from hypertension, hyperlipidemia and coronary artery disease. She has previously been diagnosed with a high-grade stenosis of the right internal carotid artery and occlusion of the left internal carotid artery, andis as well status post dilatation and stenting of the circumflex coronary artery. Additional relevant vascular disease and surgery include occlusion of the right subclavian artery, aortobifemoral bypass grafting due to high-grade stenosis, and occlusion of the common, external and internal iliac arteries on both sides. [...] ...
Aortic archesâ€"On both sides, the common carotid artery is derived by an elongation of that segment of the horn of the aortic sac between the origins of the third and fourth aortic arches. The proximal segment of the internal carotid artery is formed by the third aortic arch, its distal segment by the cranial extension of the paired dorsal aorta rostral to the carotid duct. The external carotid artery, a new vessel, joins the internal carotid artery at its point of origin. On the left the distal part of the definitive aortic arch is formed by the fourth aortic arch and the segment of the paired dorsal aorta between the carotid duct and the seventh dorsal intersegmental artery; on the right side these segments form the proximal part (base) of the right subclavian artery. The proximal part of the sixth arch on each side becomes the stem of the right or left pulmonary artery. Its distal part on the right loses its connection with the dorsal aorta and disappears. The connection with the dorsal ...
Aortic archesâ€"On both sides, the common carotid artery is derived by an elongation of that segment of the horn of the aortic sac between the origins of the third and fourth aortic arches. The proximal segment of the internal carotid artery is formed by the third aortic arch, its distal segment by the cranial extension of the paired dorsal aorta rostral to the carotid duct. The external carotid artery, a new vessel, joins the internal carotid artery at its point of origin. On the left the distal part of the definitive aortic arch is formed by the fourth aortic arch and the segment of the paired dorsal aorta between the carotid duct and the seventh dorsal intersegmental artery; on the right side these segments form the proximal part (base) of the right subclavian artery. The proximal part of the sixth arch on each side becomes the stem of the right or left pulmonary artery. Its distal part on the right loses its connection with the dorsal aorta and disappears. The connection with the dorsal ...
A 56-year-old man with a 60-pack-year history of smoking suffered a right sided stroke three months prior to the present admission. Ultrasound showed evidence of occlusion of the right internal carotid artery. Subsequent magnetic resonance angiogram (MRA) was read as a focal 20 mm occlusion of the right internal carotid artery with probable distal reconstitution ...
Object. The purpose of this study was to determine whether the preoperative measurement of acetazolamide-induced changes in cerebral blood flow (CBF), which is performed using single-photon emission computerized tomography (SPECT) scanning, can be used to identify patients at risk for hyperperfusion following carotid endarterectomy (CEA). In addition, the authors investigated whether monitoring of CBF with SPECT scanning after CEA can be used to identify patients at risk for hyperperfusion syndrome.. Methods. Cerebral blood flow and cerebrovascular reactivity (CVR) to acetazolamide were measured before CEA in 51 patients with ipsilateral internal carotid artery stenosis (≥ 70% stenosis). Cerebral blood flow was also measured immediately after CEA and on the 3rd postoperative day.. Hyperperfusion (an increase in CBF of ≥ 100% compared with preoperative values) was observed immediately after CEA in eight of 12 patients with reduced preoperative CVR. Reduced preoperative CVR was the only ...
Ischemic stroke results from the occlusion of a brain artery by a clot. Early revascularization by thrombolysis and thrombectomy promotes neurological recovery by saving the area of ischemic penumbra. Progression of ischemic stroke is evaluated on multimodal imaging by the mismatch ratio between necrotized core and salvageable hypoperfused volumes.. Migraine affects 12% of the population. Although considered as a benign condition, migraine, particularly with aura, is a risk factor for ischemic stroke. Based on pathophysiological hypothesis and the result of one study, which had several limitations, its suggest that migraine might increase the sensitivity to cerebral ischemia and induce a faster infarct growth.. The main objective of the study is to determine if the mismatch ratio between irreversibly injured and hypoperfused volumes, measured on initial imaging (MRI or CT) during acute ischemia due to occlusion of the middle cerebral artery or the intracranial internal carotid artery, varies ...
Carotid artery tear. Coloured lateral digital angiogram (X-ray) of a 43-year-old woman with a dissection (tear) of the left internal carotid artery (pink line, upper centre), caused by a sports injury. The spinal column can be seen (centre) along with the base of the skull (top). A dissection is a tear within the wall of a blood vessel. This allows leaked blood (haematoma) to separate the wall layers, creating a pseudoaneurysm (false aneurysm). This causes a narrowing of the artery and can completely block the flow of blood. Carotid artery dissection is the main cause of stroke in young people. - Stock Image C001/8118
Dempsey RJ, Wilbrand SM, Wesley UV, Varghese T, Kalluri H, Hermann BP. Clinical Risk Factors predisposing to Vascular Cognitive Decline in Atherosclerotic Patients. Abstract for ESOC 4th European Stroke Conference. May 16-18, 2018, Gothenburg (Sweden).. Meshram NH, Mitchell CC, Hermann BP, Wilbrand SM, Dempsey RJ, Varghese T. Comparison of Directional Strains to Principal Strain for in Vivo Carotid Plaques. Accepted for Oral presentation at the 2018 AIUM Convention, March 24-28, 2018, New York, NY.. Steffel CN, Samimi K, Varghese T, Salamat S, Wilbrand SM, Dempsey RJ, Mitchell CC. Quantitative Ultrasound Parameters for In-Vivo Characterization of Carotid Plaque. Submitted as poster to the Cardiovascular Research Center Poster Fair. December 5th 2017. UW-Madison.. Meshram N, Mitchell CC, Herman BP, Wilbrand SM, Jackson DC, Dempsey RJ, Varghese T. Carotid Plaque Instability Quantification using Strain indices from Multiple Regions of Interest in Carotid Plaque in human subjects. Cardiovascular ...
Patients treated medically showed increasing risk of stroke with age and degree of internal carotid artery stenosis (see accompanying figure). The degree of stroke risk reduction with surgery was also found to vary with age and degree of internal carotid artery stenosis, but the oldest patients demonstrated the greatest benefit and had the lowest rates of perioperative complications. In patients with more than 70 percent stenosis, the stroke risk reduction and perioperative risk of stroke and death were 28.9 and 5.2 percent for patients older than 75 years. In those aged 65 to 74 years, the comparable figures were 15.1 and 5.5 percent, and in patients younger than 65 years, the stroke risk reduction was 9.7 percent and the perioperative risk of death or stroke was 7.9 percent. In patients with stenosis of 50 to 69 percent, the risk reduction for stroke within two years was only statistically significant in patients older than 75 years.. The authors conclude that, in patients older than 75 years, ...
The internal carotid arteries branch off the common carotid arteries in the neck just below the mandible. They give off no branches until meeting with the communicating branches of the basilar artery. The basilar artery is formed by the two vertebral arteries which arrive at the posterior of the brain via the vertebral column. Together the basilar and internal carotid arteries form the Circle of Willis, the primary vasular structure supplying blood to the brain. Blood from the internal carotids primarily goes to the frontal and temporal lobes. ...
what does mild, 20%, stenosis in the origin of the left internal carotid artery, mean? A mild, 20%, narrowing is seen in the proximal left internal carotid artery. 1. Dominant left vertebral artery w...
July 21, 2011 Health Care, Medicine, Social Health Community 275 Comments Measuring maximum intima-media wall thickness of the internal carotid (neck) artery may boost the predictive power of Framingham risk scores as per Dr Joseph Polak, of Tufts University, and colleagues who reported their findings in the New England Journal of Medicine.. 1.  Thickening in both arteries is used as a surrogate measure of atherosclerosis.. 2.  In the common carotid it manifests as diffuse arterial wall thickening. 3.  In the internal carotid artery, its a surrogate for focal atherosclerotic plaque. 4. Both are recognized tools for cardiovascular risk assessment. 5.  To clarify the issue, Polak and colleagues analyzed data from 2,965 patients in the Framingham Offspring Study who were followed for an average of 7.2 years, and 296 of them had a cardiovascular event during that time.. 6.    Plaque is defined as an intima-media thickness of more than 1.5 mm in the internal carotid artery. ...
70 years old male patient who had history of intermittent cludication and had carotid stenting in 2007. He is diabetic hypertensive and smoker fr 40 years with 40 cigrates per 2r hours. He had 100 percent stenosis of abdominal aorta which was the cause of cludication beside that had 100 percent stenosis of left internal carotid artery and right internal carotid was more thn 95 percent so he had carotid stenting and nw there is stenosis of 65 percent. He had all these procedure back in 2007. Since than he is on loprin 75mg od Lowplat 75mg od And pletaal 100mg od Diovan 80mg od Concor 2.5mg od Lipiget 20mg hs My question is what is the role of cilostazole in periphral vascular oculusive disease and this pt is on double anti coauglant since 2007 so should he be on all these drugs like lowplat loprin and pletaal. There are no active complains he is hving good colatrals and can walk easily.
Atherosclerosis is common at the bifurcation of the common carotid artery. The risk of stroke increases with the degree of stenosis
The embryologic development of cerebral circulation is a natures miracle. At approximately 30-days of gestation, the internal carotid arteries (ICAs) arise from dorsal aortic arches and anastomose with longitudinal neural arteries to form a primitive vertebrobasilar system at four major sites [1] named according to their neighbouring structures as trigeminal, otic, hypoglossal and proatlantal intersegmental arteries. Failure of regression of these vessels lead to persistent primitive carotid-vertebrobasilar anastamoses of which most cephalic and most common is PTA [1]. Its reported prevalence is 0.1%-0.6% [2] of cerebral angiograms. Internal carotid artery gives origin to PTA which then anastomoses with the midbasilar artery. Basilar artery is usually hypoplastic caudal to this anastomosis [2 ...
article{cbca5c8b-b339-484a-b865-855a9238e2be, abstract = {OBJECTIVE: To compare the rate of ischemic events and intracranial hemorrhage in the long-term follow-up of patients with persistent and transient severe stenosis or occlusion of the internal carotid artery (ICA) due to spontaneous dissection (ICAD). METHODS: One hundred and sixty-one consecutive patients with unilateral ICAD causing severe stenosis or occlusion were examined clinically and by ultrasound 1 year after symptom onset. Forty-six cases with persistent and 46 age- and latency-matched cases with transient (recanalization complete or less than 50% stenosis) severe stenosis or occlusion of the ICA were enrolled. Nine patients with surgical, endovascular, or fibrinolytic therapy for ICAD or associated stroke were excluded. Antithrombotic therapy was given at the discretion of the treating physician. Clinical follow-ups were done annually. RESULTS: Antithrombotic therapy and follow-up were similar in patients with permanent (6.2 +/- ...
Severe asymptomatic stenosis of the internal carotid artery (ICA) leads to increased incidence of mild cognitive impairment (MCI) likely through silent embolic infarcts and/or chronic hypoperfusion, but the brain dysfunction is poorly understood and difficult to diagnose. Thirty cognitively intact subjects with asymptomatic, severe (≧70%), unilateral stenosis of the ICA were compared with 30 healthy controls, matched for age, sex, cardiovascular risk factors and education level, on a battery of neuropsychiatric tests, voxel-based morphometry of magnetic resonance imaging (MRI), diffusion tensor imaging and brain-wise, seed-based analysis of resting-state functional MRI. Multivariate regression models and multivariate pattern classification (support vector machines) were computed to assess the relationship between connectivity measures and neurocognitive performance. The patients had worse dizziness scores and poorer verbal memory, executive function and complex visuo-spatial performance than controls.
Atherosclerotic stenosis of common and internal carotid arteries is a well-recognized risk factor for ischemic stroke, and revascularization has been proven to be the main tool of prevention, particularly for patients with stenosis-related symptoms.
Internal carotid stents and angioplasties can reduce your stroke risk. Call stroke specialist Dr. Taqi in West Hills and Thousand Oaks: 805.242.4884 for info.
An 82 year old man with severe bilateral (90% on the right side, 80% on the left side) stenosis at the origin of the internal carotid artery (ICA), demonstrated by ultrasound, and recurrent transient ischaemic attacks causing weakness of the left arm was referred for stenting of the right ICA. The patient was pre-treated with aspirin and clopidogrel and the activated clotting time … ...